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The foc.us tDCS Headset, Review Part 4, Electrode Placements

Note: If you are new to tDCS and/or the foc.us headset, may I suggest that you read parts one through three before reading this post. You’ll better understand what I present here if you have a little context. Also, you might want to know that the default “built-on” electrode configuration for the foc.us headset addresses one depression and learning/memory montage “right out of the box”.

Great Product!

The more I have used this headset, the more I have come to believe that it is an almost ideal tDCS device. It’s features and versatility make it a breeze to setup and a pleasure to use. I have become a real fan of not being tethered to a traditional tDCS device – wires, box, electrodes, head-band(s), etc. My guess is that foc.us will be VERY successful – ultimately selling these headsets to end-users, medical practitioners, and the research community.

Electrode Placements

I’ve had repeated requests to show electrode placements for various scenarios using the foc.us headset. As you look at these, remember, they are just examples. There are alternative placements and new tDCS montage information being published almost every day! What I hope to convey is the versatility the foc.us headset provides through various electrode placements. So here we go…

DEPRESSION

The most common depression treatment using tDCS places the anode at F3 (high on the left forehead) and the cathode at FP2 (just above the right eye on the forehead). See below…

(The unusual foc.us “built-on” electrode placement puts the anode at FP1 and F3 and the cathode at FP2 and F4. So yes, it supplies current in the general area suggested for depression treatment. Has this unusual arrangement been scientifically studied? Not to my knowledge. There is anecdotal evidence that indicates that it works. BTW Notice the air-gap between the sponge and the “head” in the upper right of the photo. Be careful when you put the headset on your “real” head that there are no air-gaps.)

“SAVANT” LEARNING

This montage is been in the press of late and is easy to do with the foc.us headset with the accessory kit. Normally, the anode is placed at about T4 (the right temple) and the cathode at about T3 (the left temple.)

(The accessory kit includes wire electrodes that connect to the back of the headset. You can then attach the electrodes wherever your montage requires.)

(If you use the wire electrodes, remember that the “built-on” electrodes remain active. You can use them if appropriate or remove the sponges to not use them. In this case, the built-on electrodes are not used at all – in fact you can take the headset off and set if on your desk – or do what I do, just let it rest on your neck.)

(If using the wire electrodes, the headset does not need to be on your head!)

MEMORIZATION and LEARNING

An interesting memorization and learning montage involves placing the anode at FP1 (above the left eye on the forehead) and the cathode at FP2 (above the right eye on the forehead).

(There are other variations of “learning” electrode placements on the web.)

(As with the depression montage shown earlier, the unusual placement of the built-on electrodes is “more” than required for this montage. Possibly the upper sponges could be left out to more precisely match the montage requirements. However, current density could be too high or irritation might result as the sponges are small. Research is needed! An alternative is to use the wire electrodes and not put the headset on the head at all.)

CHRONIC PAIN

Chronic pain is addressed in at least a couple of different montages. One example is to place the anode at C4 (above the right ear, halfway to the center of the head) and the cathode at FP1 (above the left eye on the forehead). There are other montages for chronic pain – so look those up on the web if the one I show is not what you are looking for.) Another montage places the anode at either C3 or C4 and the corresponding cathode at FP1 or FP2 on the same side of the head (left or right) to treat chronic pain on the opposite side of the body (left or right).

(This is another example of how versatile the foc,us headset can be. Use the wire electrodes for this chronic pain montage and set the headset on your desk or leave it resting on your neck – with no sponges.)

Wrap-Up

So there you are – four examples of tDCS montages using the foc.us headset. What a great and versatile product. It’s unfortunate that the default treatment in time in the headset is 10 minutes. The norm in tDCS treatment is 20 minutes (sometimes 30 minutes.) Once the iOS and Bluetooth issues are resolved, changing treatment time will be the first thing I do! In the interim, once one session is complete, you can simply touch the button on the back of the headset one time to repeat a 10 minute treatment.

How else can I help you with this headset or tDCS in general? Please feel free to send me an email at brent@speakwisdom.com

I’m enjoying your blog on the foc.us, hope you keep it up. But I haven’t seen much here yet on what I would consider to be the most important question: Does it work? My particular interest would be in how much, if any, it is promoting improved long term memory retention.

This is more of a general tDCS question: Prior to your first tDCS session (be it with the foc.us device or not), did you, first, establish a baseline, in order to determine the effectiveness of the treatment? If so, what did you use to establish that baseline? I plan on establishing one, prior to using my foc.us (and accessory pack)…when it finally arrives. I need your advice as to how to do that. Did you use a website service, such as lumosity? I look forward to your reply!.
Andrew

Because I was not conducting a “scientific study”, I did not establish a baseline. All the feedback I have received I consider anecdotal. But with so many reporting progress, it leads me to believe that tDCS is helpful. I’d be curious to hear how your experience goes – particularly if you do establish a baseline.

Hey Brent,
I found this “brain game” which, I feel, will provide both a baseline and a progress graph. It seems to be a simple tool that may prove useful for tDCS use. I thought I’d share it with you and your readers:

Are there any known risks or links between TCMS and any diseases that involve plaques/calcifrication of the brain? It occurs to me that electric currents might hasten these processes.

I noticed on your blog posts that 2 x 10 minute sessions = 20 minutes was a fairly standard approach for the treatment of depression. However I also noticed in the Foc.us manual that they recommend no more frequent use than every 48 hours. Do you know of any protocols using similar currents/configurations for treating depression and how often they are administered?

Would this protocol be applied best in the morning given the effects may only be felt for a few hours or does it result in a cumulative effect and thus it doesn’t matter when its done?

Given it is an emerging science with little mid to long term studies of side effects or permanent changes, do you have an precautionary suggestions, such as 10 weeks on/2 weeks off etc.

In your article you spoke of a depression montage involving placing the anode (from memory) on the right shoulder. Can you please tell me where on the shoulder or point me to a montage?

I also suffer from tinnitus and have seen elsewhere that electrical stimulation of the vegus nerve combined with tones to rewire the brain’s auditory processing circuits. However I am conscious that this area is getting closer to the brain stem. Are you aware of anyone using the Foc.us for this treatment?

Finally, you seem to be the only person on the internet sharing information about Foc.us and depression. Are you aware of anyone else doing this? I am very keen to start discussions with other sufferers of depression who are using TCMS and ideally Foc.us to treat themselves.

Sorry about all the questions, thanks in advance for anything you can share:)

I’m not an MD, so am not qualified to answer some of your questions. I suggest you review the studies that are posted on the web. What appears below is my opinion only:

Are there any known risks or links between TCMS and any diseases that involve plaques/calcifrication of the brain? It occurs to me that electric currents might hasten these processes.

(I know of no studies suggesting a link between TCMS / tDCS and plaques / calcification.)

I noticed on your blog posts that 2 x 10 minute sessions = 20 minutes was a fairly standard approach for the treatment of depression. However I also noticed in the Foc.us manual that they recommend no more frequent use than every 48 hours. Do you know of any protocols using similar currents/configurations for treating depression and how often they are administered?

(I’m not sure how foc.us came up with their default. It does not correspond to any tDCS study I have read. 20 or 30 minutes daily is a fairly common treatment time.)

Would this protocol be applied best in the morning given the effects may only be felt for a few hours or does it result in a cumulative effect and thus it doesn’t matter when its done?

(My experience is time is not critical – though some report being kept awake when they use tDCS in the evening.)

Given it is an emerging science with little mid to long term studies of side effects or permanent changes, do you have an precautionary suggestions, such as 10 weeks on/2 weeks off etc.

(I suggest following the published study protocols – which typically treat for 30 or 60 days – then periodic repeat treatment as required.)

In your article you spoke of a depression montage involving placing the anode (from memory) on the right shoulder. Can you please tell me where on the shoulder or point me to a montage?

(Cathode goes on the right shoulder, not the anode. This is commonly done in published studies. Where on the shoulder does not seem to be critical.)

I also suffer from tinnitus and have seen elsewhere that electrical stimulation of the vegus nerve combined with tones to rewire the brain’s auditory processing circuits. However I am conscious that this area is getting closer to the brain stem. Are you aware of anyone using the Foc.us for this treatment?

(I am not aware of any. However there are published accounts of using tDCS to treat tinnitus.)

Finally, you seem to be the only person on the internet sharing information about Foc.us and depression. Are you aware of anyone else doing this? I am very keen to start discussions with other sufferers of depression who are using TCMS and ideally Foc.us to treat themselves.

(The focus.us headset is so new that there are no studies using it that I’m aware of. However, tDCS studies abound. It seems to have a very positive effect on many (most) with depression.)

Sorry about all the questions, thanks in advance for anything you can share:)

I have a question, for the montages listed above, is cathode placement at the suggested sites critical? For example, in the memorization and learning montage, I typically use an anode at FP1 or FP2 to increase activity and a cathode on the opposite shoulder to complete the circuit without creating a decrease in activity at another location in the brain. I do the same with F1 anode placement. In your opinion, how critical is the cathode placement in your montages. Does closer placement create a stronger or more directed current? More importantly, is cathode placement and lowering activity at that region of the brain critical to the montage. An example I can think of is using tDCS for OCD where you would want to lower activity in a region of the brain and cathode placement becomes more critical to the montage than anode placemant. (in this case Cathode placement between F4 and Mid-line, anode placement on the shoulder.)

Yes – according to the studies I’ve read, cathode placement does matter. Either it’s on the shoulder so tDCS effect is from the anode only or it’s on the head having a negative effect (lowering effect) under the area where placed – while the anode has it’s positive effect. It’s all about current density. Placing an electrode on the shoulder effectively reduces current density in the brain from that electrode to the point where it has no effect.

So it’s a tradeoff? For example your depression montage places the cathode at FP2. This will lower activity at this location potentially affecting cognition, correct? I wonder if a second 20 minute session with the anode at FP2 after the first session would counteract this or would it be unhealthy? I have been using the montage in this phase 3 study for ADHD which places the cathode on the contra-lateral mastoid though I have been using the shoulder close to that location.

ADHD is an area just beginning to receive attention in the world of tDCS. What I have found in studies shows placing the anode at F3 and the cathode at FP2. You should continue to search as, again, this is a developing area of interst and research.

Thank you so much for this series of posts and guidelines. It’s because of this information that I felt confident in buying a unit of my own.

My personal review in a nutshell, I used it for 10 minutes a day at max power on the constant stimulation setting. After two months, I feel more alert and aware than I did previously. I also have very mild depression, which I feel is more or less gone after two months of use. I didn’t do any pre/post tests on myself, but I have some scheduled for friends and I’ll post the results.

I had a question for you as well. The literature says to use for about 20 minutes for 30 to 60 days, (I mid-lined with 60 ten minute days) and then to continue “as needed”. Can you expand on that since I’m at the end of my daily use schedule? Should I use it once in a while, wait till I feel like I need it again, wait for a while then do every day again, etc?

Hi!
The suggestions I’ve read is to use tDCS again when you notice the need – and use it for 3-5 days. You should return to depression “gone” state. You can repeat as needed according to those I have spoken with.
That’s the real beauty of tDCS – no pills to take (buy) – you own the device that gives you freedom from depression to use as you deem appropriate.
Brent

Hi,
May I know how to place the external electrodes that come with foc.us over the scalp as the hairs intervene and is that ok to place the external electrodes directly over the hairs on the scalp and keep secured with tape or something like that?Of course that is after applying saline or gel to the surface of electrodes for better conductivity.
Also what would be montage for right side hemianopsia(due to left sided occipital visual cortex infarct /stroke).
Thanks for your help.

You might do better with sponge electrodes. See my blog posts on the foc.us headset for ideas. I’m not an MD, so I have no suggestion/recommendation for electrode placement given your condition. You should contact a medical professional. Perhaps http://www.transcranialbrainstimulation.com

Thank you for all of this information. 2 questions. It seems the default foc.us setup is the same as the one you recommend for learning. Is there any difference? Also, do you know of any sites that show other montages for specific tasks, such as math, music, other memory sites, etc. Or will you be providing some more on your blog?

The first time I used the foc.us device was the default ,8 ma, and 10 minutes. That was a week ago. Within a half hour I booted up the Ultimeyes app I use to help my brain realize after having cataract surgery in both eyes that I”m no longer blind. My vision in both eyes was 20/20 or better, but my brain still acted according to it’s old habits.

Infrequently the Ultimeyes app tests the user to revamp the sessions according the improvements made or not. Previously my efforts had been only so-so. After my first session with the foc.us device I made a perfect score. I was delighted.

There has been mention of the possible need to reverse the electrodes for left-handed people for certain montages. I don’t think that would apply to the savant montage though. Usually I see mention in the treatment of depression (left/right reverse).

This is an area that needs more study so specific recommendations can be made. tDCS, like aspirin, affects people in sometimes unpredictable ways – so close monitoring is always required.

“The unusual foc.us “built-on” electrode placement puts the anode at FP1 and F3 and the cathode at FP2 and F4.”

It seems simply wrapping electrical tape over the FP1 anode and F4 cathode on the headset make this a more effective/accurate depression montage? I would appreciate your thoughts on that idea and any possible issues with using electrical tape to block the electrical currents.

My main concern would be that the remain electrode surface area would be pretty small. That might result in skin irritation or burns or worse. I think you would be better off to get some Amrex 3x3s and plug those into the headset.

Hi, I just saw this block post via google search, and I haven’t read through it all, but have you kept up on it? I just bought the Foc.us Go Flow. I’m using to speed up learning curve and their little package says to put X on left side of forehead, and Y on right shoulder. Noticing the gel leads turning brown so clearly theres burning going on. It says dont put the leads in random places but I was thinking putting them on the sides of my forehead rather than head and shoulder. What are your thoughts? Have you seen the Go Flow?